MEDICARE: HANNAH DVORAK DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	8788	AZ

General Provider Information

NPI Number	:	1841757960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH DVORAK DC

Provider Business Mailing Address
First Line	:	4747 E ELLIOT RD STE 32
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-1630
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4747 E ELLIOT RD STE 32
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-1630
Country	:	US
Telephone Number	:	480-307-9904
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2019
Last Update Date	:	02/25/2019

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Directions to “ HANNAH DVORAK DC” Practice Location

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